OBJECTIVES: To investigate the cost effectiveness of Hyperbaric oxygen therapy (HBOT) for the treatment of non-neurological soft tissue radiation injuries. METHODS: The economic evaluation adopted a decision analytic framework comparing HBOT to usual care for the treatment of non-neurological soft tissue radiation injuries. The incremental costs per patient wound healed/improved were presented. Estimates of effectiveness were obtained from a published RCT (Clarke et al, 2008). Resource use was determined from HIC data (Medicare and Pharmaceutical Benefits Schemes), the Australian Department of Health and Ageing and expert opinion. RESULTS: For the base case analysis, significant/moderate improvement or complete wound healing was demonstrated in 88.9 per cent of patients who received HBOT for soft tissue radiation injuries, and the comparable figure for usual care was 62.5 per cent of patients. Therefore providing HBOT would result in an additional 26.4 per cent of patients being successfully treated. The average cost accrued in the HBOT-treated group was $11,753 per patient compared to $12,482 in the usual care group. This represents a cost savings of $728 per patient, meaning that HBOT dominates usual care (i.e. HBOT is less expensive and is more effective). CONCLUSIONS: The results indicate that HBOT is a cost-effective alternative to usual care for the treatment of soft tissue radiation injuries. There is considerable uncertainty around the estimates of usual care due to the complexity of the treatment pathway.